IFP Quality Review and Audit Analyst
The Cigna Group
full-time
Posted on:
Location Type: Remote
Location: Remote • 🇺🇸 United States
Visit company websiteSalary
💰 $25 - $38 per hour
Job Level
JuniorMid-Level
About the role
- Conduct medical records reviews with accurate diagnosis code abstraction
- Utilize HHS’ Risk Adjustment Model to confirm accuracy of Hierarchical Condition Categories (HCC)
- Identify all valid data elements and opportunities for data capture
- Perform documentation and data audits identifying gaps and compliance risks
- Collaborate with team members and matrix partners to facilitate coding and Risk Adjustment education
- Communicate effectively across all audiences
- Develop and implement internal program processes
Requirements
- High school diploma
- At least 2 years’ experience in medical documentation audits and medical chart reviews
- Proficiency with ICD-10-CM coding guidelines and conventions
- Familiarity with CMS regulations for Risk Adjustment programs
- Computer competency with excel, MS Word, Adobe Acrobat
- Detail oriented, self-motivated, excellent organization skills
- Understanding of medical claims submissions preferred
- HCC coding experience preferred
Benefits
- Medical, vision, dental, and well-being and behavioral health programs
- 401(k) with company match
- Company paid life insurance
- Tuition reimbursement
- Minimum of 18 days of paid time off per year
- Paid holidays
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
ICD-10-CM codingmedical documentation auditsmedical chart reviewsdata auditsdiagnosis code abstractionHCC codingdata capture
Soft skills
detail orientedself-motivatedexcellent organization skillseffective communication